CardioPsy - Cardiac function in schizophrenia
Research type
Research Study
Full title
Investigating metabolic, inflammatory, structural and functional cardiac changes in serious mental illness
IRAS ID
281300
Contact name
Oliver Howes
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Patients with major mental illnesses (SMI) such as schizophrenia live about 20 years less than the general population, of which about 12 years are lost to cardiovascular disease (CVD). Despite the wealth of epidemiological evidence for an association between serious mental illness (SMI) and CVD, it is unclear if SMI is associated with cardiac dysfunction, or how to address this.
Our previous work showed biventricular volume reductions, evidence of concentric cardiac remodelling and of fibrosis/inflammation of the myocardium in chronic patients with schizophrenia as compared to matched healthy controls in the absence of concurrent established metabolic or medical risk factors. These are prognostically adverse changes, and, in the absence of concurrent conventional metabolic or medical risk factors, could explain part of the additional cardiovascular morbidity and mortality seen in schizophrenia. However, as most of the patients in our study were taking antipsychotics and had chronic illness it is not clear if changes are secondary to antipsychotics and/or develop over time. This is important to inform potential preventive intervention.
This study will allow to extend the sample and to disentangle the role of antipsychotic medication and of chronicity in causing cardiac changes by also recruiting patients in their first episode of psychosis. Furthermore, no previous study has investigated the association between cardiac changes and other aspects of brain function, body fat, or blood markers of inflammation or dysmetabolism (metabolic syndrome and diabetes). We aim to determine this using a case-control longitudinal study. The case-control design will determine the association between cardiac structure and function and other measures in patients with psychosis relative to controls. However, as a further step towards finding a causal relationship, we will follow-up volunteers at 2 timepoints, and repeat all measures to determine if there are changes over time. It is expected that patients (especially those in their first episode of psychosis when first scanned) will have been on treatment with different antipsychotics and will have started to show measures of outcome, such as remitting or relapsing, which will allow us also to use baseline data to predict outcomes. This will be a longitudinal study.REC name
North of Scotland Research Ethics Committee 1
REC reference
20/NS/0084
Date of REC Opinion
31 Jul 2020
REC opinion
Favourable Opinion